Hepatitis Information

Hepatitis is an infection of the liver caused by bloodborne pathogens. Hepatitis B is the most important virus to learn about and is the one addressed in this program.

Hepatitis B Virus (HBV): 1 to 5% of U.S. population have had HBV infection, but some groups of people have rates of infection 10 times higher. HBV is the most likely to be encountered in the workplace. HBV infects over 80,000 workers and kills ~200 each year. There is an effective and safe vaccine available that can protect you from HBV infection. HBV is as much as 100 times more easily spread than HIV. Following HBV infection, it takes at least 6 weeks until illness occurs, and it may take as long as 6 months since exposure to the virus. You have ~30% chance of developing a more serious case of hepatitis with symptoms such as fever, chills, abdominal, muscle and joint pains, fatigue, nausea, skin rash, jaundice, and dark urine. ~1% die from HBV infection, but most recover completely. Chronic persistent hepatitis occurs when HBV remains in the body for years, but causes few problems. The individual remains infectious. Chronic active hepatitis results from HBV remaining in your liver for years and slowly causing cirrhosis. Once cirrhosis develops, you have a greater than average chance of developing cancer of the liver.

Hepatitis C Virus (HCV): The hepatitis virus most similar to HBV and spread the same way. People with both HBV and HCV are more likely to develop cirrhosis or liver cancer than those with just one of the viruses. Currently, there is no effective treatment or vaccine against HCV.

Many people infected with Hepatitis C have no symptoms. Over 80% of those infected with HCV become chronic carriers of the virus. Recent estimates show that there may be as many as 5 million HCV chronic carriers in the United States. At least half of all HCV carriers will develop chronic liver disease, regardless of whether or not they have symptoms.

Hepatitis D Virus (HDV): Causes infection only in those people who already have HBV infection. HDV is spread in the same ways as HBV, but it is less contagious. It is much less common in the United States than in Africa and South America.

Hepatitis A Virus (HAV): The most common type of Hepatitis in the United States. Infection usually spread by food or water that has been contaminated by sewage. It is rarely spread by sex, transfusions, or dirty needles. If you contracted HAV infection, you would probably be very ill for a few weeks and then recover completely. Rarely causes chronic liver disease, cirrhosis, liver cancer, or death. Infected people are able to spread the infection for only a few weeks.

Hepatitis E Virus (HEV): Almost identical to HAV infection, but it is rare in the United States.

Other Bloodborne Pathogens: These infections can be spread through the blood or other body fluids, and could be contracted while working. Most of these diseases are rare in the United States and are even more rarely transmitted in the workplace. These infections include: babesiosis, bartonellosis, cytomegalovirus, human parvovirus, leishmaniasis, Epstein-Barr virus, Human T-Lymphotrophic Virus-I, Q fever, syphilis, toxoplasmosis, American trypanosomiasis, and yersiniosis.

Hepatitis C virus (HCV) infection is found in 0.5% to 8-0% of blood donors worldwide. Because the infection is chronic in more than 60% of infected persons, the disease is an important public health and economic problem. The management of patients with chronic hepatitis C is complex--the disease is often only mildly symptomatic and slowly progressive, but 20% of patients develop cirrhosis after 20 years of infection and perhaps 10% of those with cirrhosis develop hepatocellular carcinoma. It is also an important indication for liver transplantation. In Europe and Japan the disease is more important numerically than is either hepatitis B or HIV infection. Existing antiviral agents are effective in only a minority of patients, yet good responses can be obtained. The patient presented here and his wife illustrate several of the difficulties faced by doctors. We also summarize some of the scientific advances that aid the diagnosis and treatment of this infection.

Hepatitis is an inflammation of the liver. Hepatitis C is a liver disease caused by a recently (1988) identified bloodborne virus. Hepatitis C occurs most often in people who have received a blood transfusion or who have shared needles. According to the U.S. Center for Disease Control and Prevention, approximately 3.9 million Americans are affected with Hepatitis C. Approximately 150,000 new cases are identified each year in the U.S. alone.